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July 13, 1994

DONNA SHALALA, Secretary of Health and Human Services, Defendant.


The opinion of the court was delivered by: ANN CLAIRE WILLIAMS

On July 16, 1991, plaintiff Georgia Kotsilieris ("Kotsilieris") filed an application for disability insurance benefits and for supplemental security income under Title II and Title XVI of the Social Security Act. Kotsilieris alleges that she has been disabled since March 19, 1991, due to arrhythmia, cardiac arrest, panic attacks, and agoraphobia. Her application was denied initially and upon reconsideration. Kotsilieris then filed a timely request for a hearing before an Administrative Law Judge ("ALJ"). A hearing was held on September 16, 1992 before ALJ John L. Mondi. Dr. Sheldon Slodki, a medical expert, was also present at the hearing. On December 23, 1992, the ALJ issued a decision finding that the plaintiff was not entitled to disability benefits because she retained the residual functional capacity ("RFC") to perform her past relevant work. (R. 60). This became the final decision of the Secretary of Health and Human Services (the "Secretary") when the Appeals Council denied plaintiff's request for review on April 26, 1993. (R. 4-6). Both parties moved for summary judgment, and the plaintiff moved in the alternative for remand. For the reasons stated below, the plaintiff's motion for summary judgment is denied, and her motion in the alternative for remand is granted. The defendant's cross-motion for summary judgment is denied. This case is remanded to the Secretary for further proceedings in accordance with this opinion and order.


 I. Work History

 Kotsilieris was born in Greece on October 25, 1947, making her 45 years old at the time of the ALJ's decision. (R. 52, 73). She completed grammar school in Greece, and has had no further education. (R. 260). Kotsilieris worked for M&M Mars Candy Co. from April 1966 to February 1979 as a factory worker. The job required her to stand for 8 hours a day and lift weight of up to 10 lbs. (R. 120-121). She worked as a restaurant worker from December 1979 to May 1983. In this position, Kotsilieris spent 8 hours a day walking and standing and was required to bend frequently and lift weight of up to 10 lbs. (R. 120, 122). Kotsilieris worked for Dana Corporation as a factory worker from February 1984 to September 1989. This job involved lifting weight of up to 50 lbs., standing for 8 hours, and operating a punch press. (R. 120, 123). She worked in a printing shop from September 1990 to February 1991, a job requiring her to stand for 8 hours a day and lift boxes of up to 50 lbs. (R. 120, 124). Kotsilieris also worked for a mailing company from March 1991 to April 1991. (R. 120). She worked as a temporary employee in a factory from October 1991 to February 1992 through the Kelly Services temporary jobs agency. (R. 133). Kotsilieris testified that she was looking for work a week prior to the hearing. (R. 263).

 II. Medical History

 Kotsilieris claims that she became disabled on March 19, 1991. She testified that she began having chest pains on that date but continued to try to work. (R. 278). On April 18, 1991, Kotsilieris was admitted to the Oak Park Hospital emergency room for complaints of heart palpitations and chest pains. (R. 136). She underwent diagnostic studies there, including a lung perfusion scan, chest x-ray, blood tests, and an ecocardiogram ("EKG"). (R. 135-159). Kotsilieris was diagnosed with atrial fibrillation (essentially, an irregular heart beat). (R. 146).

 On April 21, 1991, the day after she was discharged from Oak Park Hospital, Kotsilieris was admitted to the Loyola University Hospital for symptoms of dizziness, nausea, and near syncopal episode. (R. 162). Further studies were performed at the Loyola University Medical Center in May 1991. Her EKG reports were normal. (R. 172-174). A stress examination was terminated due to general fatigue. (R. 175). Abnormal exercise stress was found, and ventricular arrhythmias were noted on the stress examination report. (R. 175). In another test, a stress/rest thallium scan produced normal results. (R. 176). An abnormal Holter test reported paroxysmal supraventricular tachycardia (excessively rapid heart action which can come and go abruptly). (R. 181).

 III. Expert Opinion

 On August 12, 1991, Kotsilieris's primary treating physician, Dr. S.C. Lin, reported that Kotsilieris experienced sharp chest pain precipitated by emotional upset, and added that the chest pain could be relieved by tranquilizers. Dr. Lin noted that Kotsilieris had frequent anxiety and panic attacks, with hyperventilation and dizziness. He further noted that Kotsilieris was limited in her ability to do work-related activities. (R. 204). Another treating physician, Dr. Frank Leya, reported on August 20, 1991 that in his opinion, Kotsilieris had no limitations on her ability to work due to her heart problems. (R. 202). On August 27, 1991, Dr. Lin gave his opinion that Kotsilieris was not suffering from a mental impairment and that he was not treating her for a mental impairment. He noted once again that Kotsilieris experienced panic attacks and that her heart rate increased at these times. (R. 215). Both Dr. Lin and Dr. Leya were treating Kotsilieris solely for her heart problems. (R. 201-206). At the hearing, Dr. Slodki was introduced as an impartial medical expert. Dr. Slodki testified that in his view as a cardiologist, Kotsilieris could perform the exertional demands of medium work. (R. 294).

 IV. Kotsilieris' Testimony

 Kotsilieris testified at the hearing that she has problems standing or sitting for very long, and that she experiences leg pains and dizziness if she does so. (R. 267). She further testified that her heart beats fast if she climbs stairs or bends. (R. 267). In terms of her ability to lift heavy objects, Kotsilieris said that she could lift the weight of a grocery bag, but noted that when she worked in a television factory at a temporary job for Kelly Services, she felt a tightening in her chest when she had to lift objects of 20 or 30 lbs. (R. 268, 278). Kotsilieris testified that she left her last job because of chest pains. (R. 280).

 V. Mental Impairment

 The record indicates that Kotsilieris suffers from an affective disorder as well as a heart ailment. Kotsilieris testified at the hearing that she is depressed a lot of the time and has problems sleeping. (R. 268). She reportedly also has minor problems with her concentration. (R. 273). When asked by the ALJ, Kotsilieris said that her appetite was all right. (R. 270). She further testified that her husband helps her a great deal with the household chores, and that he drives her places because she is afraid to drive. (R. 272). She does not visit with friends, but does spend time with her sisters. She is afraid to leave the house by herself. (R. 283-286). Kotsilieris testified that she cries everyday. (R. 282). She said that her chest pains occur two or three times a day, when she exerts herself or when she gets upset about "little things" such as unpaid bills. ...

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